ArticleWorld journal of gastroenterology2025
Prognostic factors for peritoneovenous shunt placement for refractory ascites in liver cirrhosis.
Article in World journal of gastroenterology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundRefractory ascites severely impairs quality of life in patients with liver cirrhosis (LC) and cancer-related peritonitis. For individuals who are intolerant to medical therapy and require frequent large-volume paracentesis, a peritoneovenous shunt (PVS) offers a potential treatment option. However, PVS placement is associated with high complication rates, perioperative mortality, and lacks well-defined indications.
aimTo identify prognostic factors for PVS placement and develop a novel postoperative survival scoring model for LC with refractory ascites.
methodsA total of 100 patients who underwent PVS placement for refractory ascites due to LC in our department between 1998 and 2024 were analyzed. Patients were stratified into two groups: Those who survived more than 180 days after PVS placement (L-group) and those who survived for less than 180 days (S-group). Prognostic factors were compared between groups, and four variables (sex, age, Child-Pugh score, and liver volume) were selected for the creation of a new scoring system.
resultsSignificant differences between the S- and L-groups were observed for age, sex, Child-Pugh score and preoperative liver volume. Based on these variables, we developed a scoring system as follows: 1 point each for age ≥ 60 years, Child-Pugh score ≥ 10, female sex, and preoperative liver volume < 1057 mL. Patients scoring 0-2 points were classified as PVS grade A, and those scoring 3-4 points as PVS grade B. Survival analysis showed that overall survival was significantly higher in PVS grade A compared with PVS grade B. Multivariate analysis confirmed PVS grade as an independent prognostic factor.
conclusionThe proposed PVS scoring system may be a useful tool for predicting postoperative prognosis following PVS placement in patients with LC and refractory ascites.
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